Healthcare Credit and Collections Specialist II
Requisition 78642
Category Customer Patient Services
Business Diabetes
Division Diabetes PFS
Location USA-TX-San Antonio
Relocation Relocation eligibility to be determined
Job Type Full Time - Regular
Exempt/Non-Exempt
Shift First
Travel Percentage 0
Experience Required 2 years
Education Required GED/High School Graduate
Medtronic is an Equal Opportunity/Affirmative Action Employer
Position Description
As a key member of the Patient Financial Services (PFS) customer care team, responsible for all aspects of billing, credit and collection activities including customer service with an objective of maximizing cash flow and keeping DSO to a minimum.
Following prescribed procedures and desk guidelines, performs a variety of collection tasks relating to general healthcare guidelines to collect amounts owed for pump and/or supply orders. Verifies accuracy of statements (patient and payor related) as well as other healthcare financial accounting documentation or records. Enters data into computer systems using defined computer resources and programs. Compiles data and prepares a variety of reports. May reconcile records with PFS team members and leaders; communicates with external vendors and customers (including representatives of health plans/payors.) Recommends actions to resolve discrepancies; investigates questionable data.
Executes on established departmental objectives and assignments which affect the immediate operation, but that also have full revenue cycle and ultimately company-wide financial impact.
Position Responsibilities
- Initiates follow-up activities with third-party payors regarding open claim balances; makes written and verbal inquiries to payors. Analyzes and problem solves account issues to full resolution.
- Reconcile claims/accounts to complete resolution, performing adjustment requests and updating patient accounts/claims online, utilizing appropriate transactions and consistently formatted notes that support future collection efforts and inquiries at both the insurance and customer (ie. selfpay) levels.
- Provides support for inquires from internal and external customers regarding account/claim status. Maintains updated information on patient accounts.
- Handles internal and external customer inquiries regarding account status and account history.
- Performs eligibility verifications on patient accounts as new insurance plans/carriers are identified; updates information on expired insurance plans/carriers.
- Researches issues off-line as needed with payor/patient; conducts follow-up calls with customers, initiating conference calls between insurance carrier and patients to resolve customer concerns.
- Researches and initiates refund requests due to overpayments by payor and/or patient.
- Determines when claims/accounts are deemed uncollectable; recommends and initiates bad debt write-offs procedures.
- Meets or exceeds key performance indicators measuring productivity, quality, and service level as defined by Senior Management.
- Actively participates in team initiatives and in team status meetings.
- Additional team activities, projects, and work flow as assigned.
- Service Excellence:
o Works to identify ways to and initiate processes that work towards enhanced credit and collections, and improving service levels to both internal and external customers.
o Actively participates in process and service improvement activities.
o Encourages and supports staff members in the pursuit of service excellence.
Basic Qualifications
- High school diploma or GED
- 2+ years billing and/or collections experience in a medical group, health care company, or hospital setting
- Working knowledge of various insurance plans offered by both government and commercial insurances (PPO, HMO, EPO, Medicaid, HRAs, etc).
- Demonstrated ability to read and understand the information provided on EOBs, remittance advices, and other insurance correspondence.
- Working knowledge of medical billing and collections terminology CPT, HCPCS, and ICD-9 coding.
- Working knowledge and understanding of HIPAA guidelines.
- Knowledge and experience with MS Office suite (Word, Excel, Outlook)
Desired/Preferred Qualifications
Physical Job Requirements
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